October 09, 2008

Your Questions Answered -- Wrist Pain

I'm going to devote the next few posts to something very important -- your questions. Thanks to the Skribit technology on the left hand column of the blog, I'm able to take reader suggestions for post topics. You've asked, and now I want to answer.

The first topic I'm going to tackle is wrist pain -- how to deal with it and how to modify your yoga practice around it. I don't like to offer one-size-fits-all yoga routines, as each person is unique and has different things going on in the body, so I'm offering up guidelines instead. Of course modifications should be made for each individual case. Here goes...

I've worked with a lot of folks who suffer from wrist pain. Since many of us log hours at the computer each day, our wrists take a beating. I love my ergonomic keyboard especially for this reason. Still, I do have a few exercises that I regularly practice to keep my wrists limber and pain-free.

My favorite exercise, and the one I do most often, is what I call Namaste Stretch. Simply put your hands in Prayer Pose and stretch your hands from one side to the other (for example, the left hand pushes gently down on the right hand until the right hand is at a 45 degree angle from it's original upright position.). Hold the stretch for a beat or two before stretching in the other direction.

Reverse Prayer: Put your hands together in Prayer pose but having your fingers pointing down instead of up. Do this one with your arms behind your back.

Wrist/Forearm Stretch: Get on all fours in Table pose. Turn your hands so that your fingers are pointing towards you (forearms facing front) and gently lean back. This can be an intense stretch, so lean back slowly (and stop when you feel like going further would be painful).

Wrist Realigner: I have small wrists, but if you have larger ones, this exercise may be a bit more difficult -- Circle your wrist (above the wrist bone, in the crease of the wrist) with your middle finger and thumb and squeeze the fingers together, applying a pleasant pressure.

Joint Lubricator: I suggest doing wrist circles (both clockwise and counter-clockwise), clenching and releasing your fingers (clench fingers into fists and release by straightening and spreading fingers as wide as you can), and gentle flexion and extension of the wrists (making a "stop" sign with your hand, fingers facing up, palm facing out then moving in the opposite direction with the fingers pointing down towards the ground)

Now that you have some exercises to practice throughout the day and to prepare your wrists for practice, the next question is how you modify your practice to accommodate your wrists.

When I work with folks with wrist pain, I often have them stay off their wrists and come up onto fists instead. This can be done in Down Dog, Plank, Table, and any other pose that puts pressure on the wrists. If your wrists are too sore to use fists, then I suggest other modifications:

One prop in particular is excellent in Down Dog to take the weight off the wrist -- the Three Minute Egg. I recently wrote a post about the eggs and their advantages over standard yoga blocks. Because of the eggs' rounded design, they support the forearm without putting much weight on the wrist.

Stay off your wrists altogether. Most often people think that wrist pain equals no asana. Not true. Rather than practice Down Dog, try Dolphin (that's when you bend at the elbows, resting your forearms on the ground). Did you know that you can practice Sun Salutations against a wall? You can also do a floor version of the Sun Salutation that minimizes pressure on weak and/or painful wrists.

Sun Salutations against a wall: Stand about 2-3 feet from a wall. Inhale your arms out in front of you and up alongside your ears. Exhale and fold forward. Inhale and step one foot right up to the wall and bend the knee. Brace your hands on the wall for support. On an exhale, bring the other foot up to meet the one at the wall, keeping your hands braced on the wall for support. On an inhale, lean into the wall and arch your back stretching your chin up towards the sky. On an exhale come back to standing position. Take 2-3 steps back from the wall. Repeat.

Sun Salutations on the floor (this is called Flying Cow in the Kripalu tradition): Sit on your heels to start. Inhale and stand up on your knees while raising your arms up in front of you to come alongside your ears (let your back arch). Exhale and come down, bending your elbows, resting your palms and forehead on the floor. Inhale and come onto all fours (you can come onto your fists here to relieve pressure or you can come onto your forearms instead), raising your tail and head up. From here you can either exhale into Dolphin or you can simply exhale back into the crouched position with your arms bent at the elbows, palms resting on the ground. Inhale back up to standing on knees. Exhale back to sitting on your heels. Repeat.

There you have it -- a small sample bag of tricks to help if you're suffering from wrist pain. The next few posts, I'll discuss other asked-about topics like yoga for those with sinus and migraine headaches, Internet addiction, and books that should be on every aspiring yogi's bookshelf.

Namaste!

P.S. If you have a question that you'd like to have addressed in a blog post, use that nifty little Skribit box in the left hand column.

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I broke my wrist over a year ago trying to skateboard in high-heeled wedge sandals(big mistake). After 2 surgeries I was told that I had to limit use of my wrist to survival use only and 2 lbs maximum. My favorite sun salutation included downward dog, plank, and cobra was now out of the question. Unfortunately this sun salutation and was also the way I would start my at home yoga practice. I loved the benefits of yoga and missed it so much that I tried my favorite sun salutation anyway and was in excruciating pain for a few months. I'm so glad I found this blog. I haven't yet mastered the rhythm of the modified sun salutation, but I can already tell that I will, and thereby re-energize my practice of yoga and other poses not requiring me to use my wrist. Thank you so much, I've missed yoga for quite some time. This is one of the best gifts ever! :-)

This is a great post. I was contemplating going to a free yoga workshop in my neighborhood, but will try your routine at home first. It's much more comfortable to be at home and try this than to sit with a room full of strangers. Thanks for the exersizes.

Stick-e Brands has just announced a new product for dealing with wrist pain when doing upper body weight bearing poses. The new Yoga Stick-e Wrist Saver is designed to decrease stress in the wrist joint. By elevating the heel of the hand, the Wrist Saver lessons extreme extension of the wrist making exercies much more comfortable. Check it out at www.YogaStickySocks.com

Hi Felicity --
Great question! If you're looking to strengthen the wrists without strain, you can modify downward dog. You do this by resting the palms on the ground but pressing the pads of the fingers down into the mat so that only the palms and the finger pads/tips are on the ground (the knuckles are bent and the fingers with the exception of the tips are off the ground). The hands take on a bit of a claw-like appearance. This will deliver the benefits of the posture without the strain. I would also go with joint lubrication, stretching exercises before strengthening. Often it's not that the wrists are weak -- it's that they're unstable because of tightness or nerve impingement. Rather than get overly focused on building strength, I work with students/clients on eliminating pain and opening up the area with stretches. I also use props a lot to relieve strain. I hope this is helpful.

Hi Tami --
Thank you so much for your comment. I'm thrilled that you found this post to be helpful. If you have any questions you'd like addressed on the blog, feel free to use the Skribit box in the left hand column.

Hi Diane,
Do you have any suggestions for students who suffer wrist pain, but are looking to develop stronger wrists to prevent future injury? I'm thinking of certain postures that require the engagement of the wrists without excessive pressure. While down dog might be too much, perhaps a posture like alternate arm-leg balance or cat/cow might offer the right balance. Suggestions? Thanks!